Determining the Effects of Multimodal Manual Therapy Alone and MMT along with Cognitive Behavioral Therapy on Keele STarT Back Screening Tool in Patients of Chronic Low Back Pain

Background: Low back pain (LBP) impacts 619 million individuals worldwide, leading to disability, decreased productivity, and significant economic costs. Addressing chronic low back pain (CLBP), which encompasses physical, psychological, and social dimensions, demands an integrated treatment strategy. Research indicates that combining Cognitive Behavioral Therapy (CBT) with Multimodal Manual Therapy (MMT) offers notable effectiveness. Randomized Controlled Trial (RCT). Methods: The study involved two groups: Group A, received MMT exclusively, and Group B, underwent a combination of CBT and MMT. Participants were closely matched by age and gender. Keele STarT Back Screening Tool (SBST) scores were recorded both before and after treatment to assess the risk of persistent disability, with statistical analyses performed to evaluate the effectiveness of the interventions within each group and between the groups. Results: The demographic analysis confirmed that both groups were well-matched, reducing the potential for bias in treatment outcomes. Pre-treatment SBST scores showed no significant difference between Group A and Group B. However, post-treatment, Group B exhibited significantly lower SBST scores than Group A, with a mean difference of 1.59. While both groups demonstrated significant improvements from pre- to post-treatment, the reduction was more pronounced in the CBT & MMT group. Conclusion: Combining CBT with MMT was more effective in lowering SBST scores, indicating a reduced risk of persistent disability compared to MMT alone. These findings emphasize the importance of integrating CBT with manual therapies for CLBP, reinforcing the value of a biopsychosocial approach that addresses both physical and psychological components in treatment planning.